Use of pyridostigmine alone is not protective against soman effects. Efficacy depends on rapid use of nerve agent antidotes (i.e., atropine and pralidoxime) following nerve agent exposure.

Protective garments (e.g., masks, hoods, overgarments) specifically designed for protection from chemical nerve agents are the primary means of protection against nerve agent exposure; do not rely solely on pretreatment with pyridostigmine, atropine, and pralidoxime to provide complete protection.

Do not administer pyridostigmine after soman exposure. Discontinue at first sign of nerve agent poisoning; may exacerbate effects of a sublethal exposure.

Experience of Health Care Personnel

Pyridostigmine should be administered by IV injection only by adequately trained individuals familiar with the drug’s actions, characteristics, and risks.

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What is this medicine?

PYRIDOSTIGMINE (peer id oh STIG meen) can help with muscle strength. It is used to treat myasthenia gravis.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

asthma

difficulty passing urine

heart disease

infection in abdomen, peritonitis

irregular, slow heartbeat

kidney disease

seizures

stomach or bowel obstruction or ulcers

thyroid disease

an unusual or allergic reaction to pyridostigmine, bromides, other medicines, foods, dyes, or preservatives

pregnant or trying to get pregnant

breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not crush or chew. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

other medicines for myasthenia gravis like neostigmine

quinine

This medicine may also interact with the following medications:

atropine

bethanechol

disopyramide

edrophonium

guanadrel

guanethidine

mecamylamine

medicines that block muscle or nerve pain

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Tell your doctor if your symptoms do not improve or if they get worse.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medicine and dosage times.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

breathing problems

changes in vision

muscle cramps, spasm

slow or irregular heartbeat

stomach cramps, pain

unusually weak or tired

vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the indication prescribed.

Last Updated: July 24, 2009

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